Counseling of patients about the protective measures necessary to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus ( HIV ), may be considered.
The use of Fildena offers no protection against sexually transmitted diseases. Counseling Patients About Sexually Transmitted Diseases. The safety of Fildena is unknown in patients with bleeding disorders and patients with active peptic ulceration.
In addition, the combination of heparin and Fildena had an additive effect on bleeding time in the anesthetized rabbit, but this interaction has not been studied in humans. In humans, Fildena has no effect on bleeding time when taken alone or with aspirin. There have been postmarketing reports of bleeding events in patients who have taken Fildena.
Such combinations may further lower blood pressure. Combination With Other PDE5 Inhibitors Or Other Erectile Dysfunction Therapies. If Fildena 150 is prescribed to patients taking ritonavir, caution should be used.
Safety of combined use of PDE5 inhibitors and alpha-blockers may be affected by other variables, including intravascular volume depletion and other anti- hypertensive drugs. In those patients already taking an optimized dose of a PDE5 inhibitor, alpha-blocker therapy should be initiated at the lowest dose. In those patients who are stable on alpha-blocker therapy, PDE5 inhibitors should be initiated at the lowest dose see DOSAGE AND ADMINISTRATION.
When vasodilators are used in combination, an additive effect on blood pressure may occur. There are no controlled clinical data on the safety or efficacy of Fildena in patients with retinitis pigmentosa (a minority of these patients have genetic disorders of retinal phosphodiesterases); if prescribed, this should be done with caution. Therefore, PDE5 inhibitors, including Fildena, should be used with caution in these patients and only when the anticipated benefits outweigh the risks.
Fildena should be used with caution in patients with anatomical deformation of the penis (such as angulation, cavernosal fibrosis or Peyronie's disease), or in patients who have conditions which may predispose them to priapism (such as sickle cell anemia , multiple myeloma , or leukemia ). However, there are no controlled clinical data on the safety or efficacy of Fildena in patients with sickle cell or related anemias. It is therefore recommended not to exceed a maximum single dose of 25 mg of Fildena in a 48 hour period see DOSAGE AND ADMINISTRATION , WARNINGS AND PRECAUTIONS , CLINICAL PHARMACOLOGY. Consistent with its known effects on the nitric oxide/cGMP pathway, Fildena was shown to potentiate the hypotensive effects of nitrates see DOSAGE AND ADMINISTRATION , CONTRAINDICATIONS , CLINICAL PHARMACOLOGY.
Tablets are debossed with PFIZER on one side and VGR25, VGR50 or VGR100 on the other to indicate the dosage strengths. For similar reasons you should not take Fildena if you are taking a medicine called riociguat. fildena 25 review , isosorbide mononitrate and isosorbide dinitrate (used for angina or heart failure - if you experience chest pain after taking Fildena DO NOT use nitrates to treat it)
If you experience a sudden decrease or loss of vision after taking Fildena you should contact your doctor immediately.